P6
PILOTING A SCREENING TOOL FOR OCCUPATIONAL THERAPY REFERRAL
Hamilton JV, Fielding CA, Willingham FC, Taal MW
Department of Renal Medicine, Royal Derby Hospital, Uttoxeter Rd, Derby
INTRODUCTION: Chronic Kidney Disease (CKD) and renal replacement therapy (RRT) in
particular have a profound effect upon patients’ wellbeing and quality of life (QoL). This is
predominantly due to the complications of CKD, including anaemia, fatigue, and muscle wasting.
Occupational Therapy (OT) is an integral part of the renal multidisciplinary team (MDT), and targeted
application of the high quality skills offered by occupational therapists could help to improve QoL in
dialysis patients, by enabling increased independence and self-care. The British Renal Society
Workforce Planning Document (2002) highlights the benefits of OT, however at present it is a less
established profession compared to the other allied healthcare professionals (AHPs) working within
renal services, and the role is often overlooked. With this in mind, a screening tool for OT was
designed and piloted to establish the need for OT assessment and support for haemodialysis (HD)
dialysis patients within our Renal Unit.
METHOD: A screening tool was designed, based on extensive literature review and consensus expert
opinion. The tool consists of 11 questions relating to functional ability and 3 questions relating to
patient perception of QoL, in key areas in which occupational therapists can offer their expertise to
dialysis patients. The tool was designed to be simple and quick to undertake by nursing staff, and to
have minimum impact upon current nursing workload. The tool was then piloted by HD nurses on 10
randomly chosen HD patients over a one week period. Patients were selected from all dialysis shifts to
enable the best chance of capturing the true needs of the range of HD patients within our dialysis unit.
RESULTS: 10 patients (7 male, 3 female; mean age 71.1 years, mean dialysis vintage 29.1 months)
underwent screening. Four out of ten patients screened were identified to require OT referral. All four
patients were identified to require psychological support, and 2 patients required additional physical
support (Figure 1).
Results from the Occupational Therapy Screening Tool.
6
4
2
PATIENTS WITH NO OT
NEEDS
PATIENTS WITH PHYSICAL
NEEDS
PATIENTS WITH
PSYCHOLOGICAL NEEDS
CONCLUSION: Results from this initial small pilot study are encouraging, and demonstrate that this
screening tool could be an efficient and effective way of establishing appropriate OT referral for
dialysis patients. It was found to be simple and quick to perform, and could easily be incorporated to
be part of routine nursing assessment and monitoring. It has also demonstrated that potentially a
significant proportion of dialysis patients in our renal unit would benefit from OT assessment and
support. Further larger-scale testing of the screening tool to confirm validity and reliability are now
required.